Difference between revisions of "Fall Risk"
From Patient Determinants
| Line 24: | Line 24: | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|Unsteadiness or needing support while walking are signs of poor balance. |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-4|4. I steady myself by holding onto furniture when walking at home]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-4|4. I steady myself by holding onto furniture when walking at home]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|This is also a sign of poor balance |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-5|5. I am worried about falling]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-5|5. I am worried about falling]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|People who are worried about falling are more likely to fall. |
|- | |- | ||
| Line 40: | Line 40: | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-7|7. I have trouble stepping up onto a curb]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-7|7. I have trouble stepping up onto a curb]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-8|8. I often have to rush to the toilet]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-8|8. I often have to rush to the toilet]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|9. I have lost some feeling in my feet]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|9. I have lost some feeling in my feet]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|10. I take medicine that sometimes makes me feel light-headed or more tired than usual]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|10. I take medicine that sometimes makes me feel light-headed or more tired than usual]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|11. I take medicine to help me sleep or improve my mood]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|11. I take medicine to help me sleep or improve my mood]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|12. I often feel sad or depressed]] | |style="background-color: #FFCCCC" align="left"|[[FH Fall Risk FR-9|12. I often feel sad or depressed]] | ||
|align="center"|Yes (1) | |align="center"|Yes (1) | ||
|align="center"|No (0) | |align="center"|No (0) | ||
| − | |align=" | + | |align="left"|3 |
|- | |- | ||
|style="background-color: #FFCCCC" align="right"| | |style="background-color: #FFCCCC" align="right"| | ||
Revision as of 09:35, 8 June 2015
This is a Fall Risk Questionnaire to determine the risk for falls. With a score 4 points or higher, there may be a risk for falling.
Return to the CDC Health Risk Assessments or Patient Well-Being Assessment
| Why it matters | |||
|---|---|---|---|
| 1. I have fallen in the last 12 months | Yes (2) | No (0) | People who have fallen once are likely to fall again |
| 2. I use or have been advised to use a cane or walker to get around safely | Yes (2) | No (0) | People who have been advised to use a cane or walker may already be likely to fall |
| 3. Sometimes I feel unsteady when I am walking | Yes (1) | No (0) | Unsteadiness or needing support while walking are signs of poor balance. |
| 4. I steady myself by holding onto furniture when walking at home | Yes (1) | No (0) | This is also a sign of poor balance |
| 5. I am worried about falling | Yes (1) | No (0) | People who are worried about falling are more likely to fall. |
| 6. I need to push with my hands to stand up from a chair | Yes (1) | No (0) | 3 |
| 7. I have trouble stepping up onto a curb | Yes (1) | No (0) | 3 |
| 8. I often have to rush to the toilet | Yes (1) | No (0) | 3 |
| 9. I have lost some feeling in my feet | Yes (1) | No (0) | 3 |
| 10. I take medicine that sometimes makes me feel light-headed or more tired than usual | Yes (1) | No (0) | 3 |
| 11. I take medicine to help me sleep or improve my mood | Yes (1) | No (0) | 3 |
| 12. I often feel sad or depressed | Yes (1) | No (0) | 3 |
| _____ | |||
| Add up the number of points for each "yes" answer. If the score is 4 or more, there may be a risk for falling. | (Total Score) |
